Tackling suicide requires money, not hand-wringing

By Sebastian Rosenberg

October 5, 2016 — 3.24pm

The Australian Bureau of Statistics recently published its Causes of Death data for 2015 which demonstrated an alarming jump in suicides. Nationally, the number of people who died by suicide was 3027. This upward trend has been consistent. Suicide accounted for the deaths of 2393 people in 2011. The ACT contributed to this upward trend, recording 46 deaths by suicide in 2015, or 11.6 deaths per 100,000 people, up from 9.8 in 2014. This is lower than the national average but still quite a sharp increase.

The figures have been met with the usual hand-wringing. But deeper investigation indicates we are attempting to tackle a massive public health problem with extremely poor equipment.

Mere hand-wringing is not a good enough response to the increasing number of deaths.Credit:Rob Homer

It is not easy to tell how much is spent on suicide prevention in Australia. According to the Australian Institute of Health and Welfare, this funding accounted for 2 per cent of total Commonwealth spending on mental health in 2013-14. This would equate to around $58 million. The states and territories also fund suicide prevention activities but finding this information is hard work. I can tell you that Victoria have announced spending of $27.5 million over 10 years, NSW have announced an $8 million innovation fund, Queensland just under $10m over three years and WA $13 million to 2020. I know the ACT spent $77,000 on health promotion in relation to suicide prevention between 2005-08. While the figures are hard to pin down, it would be reasonable to suggest that national suicide prevention funding would struggle to reach $100 million this year.

This seems a preposterously small amount of effort to address a public health problem taking more than 3000 lives each year. Not to mention the 65,000 su12twelve months to August 2016, there were 1276 road fatalities nationally.

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Further, a 2009 report using figures from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare estimates the economic burden of suicide on the Australian community to be $17.5 billion annually. This is because while the median age for most causes of death is 81.9 years, for suicide it is 44.5 years.

Suicide is the leading cause of death among all people between 15 and 44 years of age, the second leading cause among those aged 44-54 years. That's a lot of years of tax foregone.

I then thought to compare spending on suicide prevention with other leading causes of death. AIHW figures indicate that spending on cancer services is around $4.6 billion, cardio-vascular disease $7.7 billion and diabetes $1.5 billion. However, these most recent published figures relate to 2008-09. Spending on each of these areas would be significantly higher now. Diabetes was responsible for the deaths of 4662 people in 2015.

I realise it is not a competition and that I am on dangerous ground here, suggesting comparisons between apples with all sorts of other fruit. But I suggest that one reason why the suicide rate is increasing is because of completely inadequate funding and a disorganised, disparate national response.

Perhaps in acknowledgement of this, the federal government has recently handed responsibility for suicide prevention to the 31 primary health networks. It is unclear how the PHNs will work out what suicide prevention activities to commission and the level of expertise varies considerably across these organisations.

More is known than ever about how to prevent suicide. Promulgation of best practice is critical to ensuring all Australians can access programs which are safe and which work. It is unclear how this promulgation to PHNs will occur.

The National Mental Health Commission has called for trial sites. The federal government has already nominated one of these sites as being Townsville, focusing on the issue of suicide prevention as it affects the defence community. The NSW Mental Health Commission has already selected some trial sites of its own, to work with the Black Dog Institute in a new effort at suicide prevention. It is unclear how various national and state efforts will mesh.

More research is also urgently required. Suicide research has missed out on funding, just like the prevention programs themselves. Specialist research into Aboriginal suicide is critical, given its impact on that community.

Suicide is a leading cause of death, ranking among the most pressing public health issues facing Australia. It is unacceptable to simply wring hands and speak solemnly, using words like "tragedy", "toll" and "scourge". Australia's approach to suicide and suicidality has in fact served to engender a mystique about the issue, as if somehow there was little anybody could really do to save these 3000 people or help the 178 others who attempt suicide every day. This is plain wrong.

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The suicide prevention and mental health sector has recently heard a lot about the need to address waste and gaps, and make the most of the resources already available in the system. This may be reasonable in some situations. But with the trend data on suicide heading in the wrong direction, now is the time for well-organised and concerted action, finally backed with funding commensurate with the complexity and scale of this public health problem. If the past decade has told us anything, it is that tokenism won't prevent suicide.

Sebastian Rosenberg is senior lecturer, Brain and Mind Centre, at the University of Sydney.